Arthritis is a condition associated with swelling and inflammation of the joints, which often results in pain and restriction of movement. The most common forms of arthritis are osteoarthritis, which is a breakdown of the cartilage in the joints, and rheumatoid arthritis, which is an inflammation of the tissue lining the joints and in severe cases inflammation of other body tissues. In the joints, sustained inflammation leads to hypertrophy of the synovium and the formation of a "pannus", which spreads over the joint causing erosive destruction of the bone and cartilage. Rheumatoid arthritis occurs when the body's immune system starts attacking it's own organs (joints, bones, internal organs).
What causes Arthritis and who is at risk?
Arthritis is a result of a breakdown in cartilage or inflammation.
Cartilage protects joints and enables smooth movement by absorbing shock when pressure is placed on a joint. Without the usual amount of cartilage, the bones rub together and this causes pain, swelling (inflammation), and stiffness.
Joint inflammation can occur for a variety of reasons, including:
- Broken bones
- Infections (usually caused by bacteria or viruses)
- An autoimmune disease (where the body attacks itself because the immune system believes a body part is foreign)
- General "wear and tear" on joints
Often, the inflammation goes away once the injury has healed, the disease is treated, or once the infection has been cleared. However, with some injuries and diseases, the inflammation does not go away or the cartilage is destroyed and long-term pain and deformity results. When this happens, the disease is called chronic arthritis.
Osteoarthritis is the most common type of arthritis and is more likely to occur with increasing age. It can occur in any of the joints but is most common in the hips, knees or fingers.
Risk factors for osteoarthritis include:
- Being overweight
- Having previously injured the affected joint
- Using the affected joint in a repetitive action that puts stress on the joint (baseball players, ballet dancers, and construction workers are all at risk)
Arthritis can occur in both men and women and in individuals of all ages. Some forms of arthritis also affect children.
Types of Arthritis
As mentioned earlier, the most common forms of arthritis are Osteoarthritis and Rheumatoid arthritis. However, there are numerous forms of arthritis, including:
Symptoms of Arthritis
A person suffering from arthritis may experience any of the following:
- Joint pain
- Joint swelling
- Stiffness, especially in the morning
- Warmth around a joint
- Redness of the skin around a joint
- Reduced ability to move the joint
A doctor will first note your symptoms and will then look at your medical history in detail to see if arthritis or another musculoskeletal problem is the likely cause of those symptoms.
Your doctor will then perform a thorough physical examination to see if there is any fluid collecting around the joint (an abnormal build
up of fluid around a joint is called "joint effusion."). The joint may be tender when gently pressed, and it may also be warm and red (especially if you have infectious arthritis or autoimmune arthritis). You may also find it painful or difficult to rotate the joints in some directions (this is known as "limited range-of-motion").
After this initial physical examination, your doctor may then ask you to undertake a number of different tests, depending on what they suspect to be the cause of your symptoms. Often, you will need to have a blood test and joint x-rays. You may also need to have a test where joint fluid is removed from the joint with a needle; the fluid will then be examined under a microscope to check for infection and for other causes of arthritis, such as crystals, which cause gout.
If arthritis is diagnosed and treated early, you can prevent joint damage. Find out if you have a family history of arthritis and share this information with your doctor, even if you have no joint symptoms. In some autoimmune forms of arthritis, the joints may become deformed if the disease is not treated. Osteoarthritis may be more likely to develop if you over-use your joints. Take care not to overwork a damaged or sore joint. Similarly, avoid excessive repetitive motions. Excess weight also increases the risk for developing osteoarthritis in the knees, and possibly in the hips and hands.
See your doctor if:
- Your joint pain persists beyond 3 days.
- You have severe unexplained joint pain.
- The affected joint is significantly swollen.
- You have a hard time moving the joint.
- Your skin around the joint is red or hot to the touch.
- You have a fever or have lost weight unintentionally.
The treatment of arthritis depends on the particular cause of the disease, on the joints that are affected, on the severity of the disorder and on the effect it has on your daily activities. Your age and occupation will also be taken into consideration when your doctor works with you to create a treatment plan.
If possible, treatment will focus on eliminating the underlying cause of the arthritis. However, sometimes the cause is NOT curable, as with osteoarthritis and rheumatoid arthritis. In this case, the aim of treatment will be to reduce pain and discomfort and prevent further disability. Symptoms of osteoarthritis and other long-term types of arthritis can often be improved without medications. Making lifestyle changes without medications is preferable for osteoarthritis and other forms of joint inflammation. If needed, medications should be used in addition to lifestyle changes.
Acetaminophen and Combination Medicines
Most people can take acetaminophen without any problems so long as they do not exceed the recommended dose of 4 grams in 24 hours (taken in 4 divided doses every 4 to 6 hours). It reduces mild pain but does not help with inflammation or swelling. Acetaminophen is available as a combination with other mild pain relief medicines for mild osteoarthritic pain, and with narcotics for severe pain. Acetaminophen with aspirin and or caffeine are over-the-counter medicines. Acetaminophen with codeine, propoxyphene or narcotics are prescription medicines.